April 10, 2023

• Anxiety disorders are the most common mental health conditions in the United States, affecting 31% of the population, and are often underdiagnosed due to stigma.
• Anxiety disorders are undertreated - only 46% receiving treatment for this condition. Given costs and other barriers to treatment, many people turn to alternative ways to cope with anxiety, including using cannabis.
• While people commonly report using cannabis to effectively cope with anxiety, results from observational studies and clinical trials are inconclusive.
• THC appears to decrease anxiety at lower doses and increase anxiety at higher doses.
• CBD appears to decrease anxiety at all doses that have been tested.
• Pharmaceuticals, including cannabis, should not replace talk therapy, but rather used in combination with talk therapy.

 Anxiety disorders have become one of the top conditions for receiving medical cannabis since becoming a qualifying condition for the Pennsylvania Medical Marijuana (PAMMJ) Program in 2019. Yet, the application of cannabis as a treatment for anxiety disorders has been a controversial issue in Pennsylvania. While the media coverage surrounding this has been largely negative, it is important to understand the broader context of why so many people are seeking out cannabis for their anxiety – and reporting that it does help.

Anxiety disorders are the most common mental health condition in the United States, affecting 31% of the population at some point in their lifetime while less than half ever receive treatment for their condition.  The social stigma surrounding anxiety disorders are frequently cited as a reason why anxiety disorders are significantly under-diagnosed and under-treated. Moreover, since everyone deals with anxiety and stress to some degree as a normal part of daily life, anxiety is frequently swept under the rug which it can worsen. This is compounded by the lack of mental health professionals and a complex public and private health insurance system that does not reimburse mental healthcare providers directly, causing patients to jump through extra hoops without assurances their care will be covered by insurance. Furthermore, existing pharmaceutical therapies also come with mixed evidence while patients report less side effects as a main reason why they have replaced pharmaceuticals with cannabis to treat their medical conditions. While these pharmaceutical options may work for some, the side effects combined with the barriers of stigma and red tape to treatment cause some patients to turn to alternative treatments like cannabis for their anxiety. The research on cannabis as a treatment for anxiety is subject to change as it is very limited on a clinical level.

The effectiveness of cannabis in treating anxiety has been concisely reviewed in a report from the University of Washington, which offers several general conclusions based upon a large body of research and helped contribute to this fact sheet. First, while Pennsylvania is one of the few states where anxiety disorder is a qualifying condition, medical cannabis patients and medicinal users across the U.S. commonly report using cannabis to effectively manage and treat their anxiety. However, due to the complexities of cannabis compounds and the federal legal status of cannabis, clinical evidence demonstrating that cannabis can effectively treat anxiety is limited. The report acknowledges that observational studies have also yielded mixed results, though a potential limitation is that some studies only consider THC and CBD and do not always analyze the specific strains, ratios of cannabinoid profiles, and terpene profiles to determine dosing and subsequent effects. Overall, THC appears to decrease anxiety at lower doses and increase anxiety at higher doses while CBD appears to decrease anxiety at all doses that have been tested. Few studies have examined cannabis products with different ratios of THC and CBD, e.g., 2:1, 1:1.

Ultimately, research to date indicates a need for additional research on cannabis as a treatment for anxiety disorders. Like pharmaceuticals used for anxiety, cannabis should not serve as a replacement for talk therapy and patients should consult with a state certified cannabis clinician before using for anxiety.

Click here to download the fact sheet.